Beta-Blocker Use Is Associated With Improved Relapse-Free Survival in Patients With Triple-Negative Breast Cancer
Beta-Blocker Use Is Associated With Improved Relapse-Free Survival in Patients With Triple-Negative Breast Cancer
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DOI：
10.1200/jco.2010.33.4441
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发表时间：
2011-07-01
影响因子：
45.3
通讯作者：
Gonzalez-Angulo, Ana-Maria
中科院分区：
文献类型：
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作者：
Melhem-Bertrandt, Amal;Chavez-MacGregor, Mariana;Gonzalez-Angulo, Ana-Maria
目的探讨乳腺癌新辅助化疗患者β受体阻滞剂（BB）摄入量、病理完全缓解（pCR）率和生存结局之间的关系。患者和方法我们回顾性分析了1995年至2007年间接受新辅助化疗的1413例乳腺癌患者。在新辅助治疗开始时服用BB的患者与未服用BB的患者进行比较。采用chi(2)检验比较各组间pCR率。采用Cox比例风险模型确定BB摄入量、无复发生存期（RFS）和总生存期（OS）之间的关系。结果将使用BBs的患者（n = 102）与未使用BBs的患者（n = 1311）进行比较。接受BBs治疗的患者倾向于老年和肥胖（P < 0.001）。两组间pCR比例差异无统计学意义（P = 0.48）。在调整了年龄、种族、阶段、分级、受体状态、淋巴血管侵袭、体重指数、糖尿病、高血压和血管紧张素转换酶抑制剂的使用后，BB摄入与显著更好的RFS相关（风险比[HR]， 0.52; 95% CI， 0.31至0.88），但与OS无关（P = 0.09）。在三阴性乳腺癌（TNBC, n = 377）患者中，BB摄入与改善的RFS相关（HR, 0.30; 95% CI， 0.10至0.87;P = 0.027），但与OS无关（HR, 0.35; 95% CI， 0.12至1.00;P = 0.05）。结论在这项研究中，所有乳腺癌患者和TNBC患者的BB摄入量与RFS改善相关。进一步的研究评估β -肾上腺素能阻断对乳腺癌复发的潜在益处，重点是TNBC是有必要的。中华临床杂志，29(2):444 - 444。(C) 2011年美国临床肿瘤学会
PurposeTo examine the association between beta-blocker (BB) intake, pathologic complete response (pCR) rates, and survival outcomes in patients with breast cancer treated with neoadjuvant chemotherapy.Patients and MethodsWe retrospectively reviewed 1,413 patients with breast cancer who received neoadjuvant chemotherapy between 1995 and 2007. Patients taking BBs at the start of neoadjuvant therapy were compared with patients with no BB intake. Rates of pCR between the groups were compared using a chi(2) test. Cox proportional hazards models were fitted to determine the association between BB intake, relapse-free survival (RFS), and overall survival (OS).ResultsPatients who used BBs (n = 102) were compared with patients (n = 1,311) who did not. Patients receiving BBs tended to be older and obese (P < .001). The proportion of pCR was not significantly different between the groups (P = .48). After adjustment for age, race, stage, grade, receptor status, lymphovascular invasion, body mass index, diabetes, hypertension, and angiotensin-converting enzyme inhibitor use, BB intake was associated with a significantly better RFS (hazard ratio [HR], 0.52; 95% CI, 0.31 to 0.88) but not OS (P = .09). Among patients with triple-negative breast cancer (TNBC; n = 377), BB intake was associated with improved RFS (HR, 0.30; 95% CI, 0.10 to 0.87; P = .027) but not OS (HR, 0.35; 95% CI, 0.12 to 1.00; P = .05).ConclusionIn this study, BB intake was associated with improved RFS in all patients with breast cancer and in patients with TNBC. Additional studies evaluating the potential benefits of beta-adrenergic blockade on breast cancer recurrence with a focus on TNBC are warranted. J Clin Oncol 29: 2645-2652. (C) 2011 by American Society of Clinical Oncology